Colic is a diagnosis which is made very commonly in circles discussing child care. Colic exists. It can be very troublesome and cause significant anxiety and sleeplessness. Unfortunately I think that it is a diagnosis which is overused and often applied incorrectly.

In my own practice I regard colic as a diagnosis of exclusion or to put it another way it is my last choice as a diagnosis. For many mothers ‘colic’ simply means that the baby is crying. The most common causes of the baby’s crying are as mentioned elsewhere hunger and over-tiredness. These need to be excluded first. The hungry baby will respond to being fed; end of problem. The problem of the overtired baby I have discussed extensively elsewhere. This needs to be excluded as well before retreating to the diagnosis of colic.

The cause of colic is not known as far as I am aware. The children suffering from it are otherwise well and for most of the day behave well. Typically the child is well fed, lying in a clean dry nappy and should be going to sleep. Unfortunately they are tearful and difficult to settle. If examined by a doctor generally nothing untoward is found. The time tends to be late in the day although this is not universal. Fortunately the majority of babies grow out of colic by 12 weeks of age. What however do we do in the time while waiting for the problem to go away?

Treatment tends to have limited success. Be sure in your own mind that the baby has had sufficient to drink, check that the nappy is clean and dry, make sure that the wraps are firm while at the same time the baby is not overwrapped and hot. Some paracetamol may be helpful; if nothing else it helps the parents to know that they have done something. Once these steps have been taken it may be necessary to stand back and wait for the baby to settle. This can be hard.

The baby with colic looks and sounds very unhappy. They cry very loudly. Tears may run down their cheeks. They may pull up their legs as if in pain. Generally they are difficult to console and do not want to feed. Fortunately once you have waited the 15 or 30 or 60 minutes that the baby takes to settle they do sleep successfully and then awaken quite cheerfully as if there had never been a problem. Your thoughts may be a little ungenerous next morning when the beaming child has had you up several times overnight.

Finally a short comment on what can cause colic. Again there are no hard and fast rules and different babies behave differently, however, riding in the pusher on a windy day and driving in the car can increase episodes which we may call colic. Driving the car is interesting. Most parents find that children travel well in the car. Perhaps the noise and movement is reassuring. The problem arises after the journey. That night may be more difficult with the child being tearful and unsettled. The treatment is the same as for over-tired babies. Once the child is well fed, clean and appropriately wrapped put them down and leave them alone to achieve sleep. Again I repeat that this can be difficult and stressful for the parents particularly when it is your first child. But forewarned is forearmed.